Inhaled insulin has been supplied on a compassionate, emergent basis by Pfizer, Inc., to determine whether or not it may be a better treatment alternative for one patient with subcutaneous insulin resistance. A regimen of inhaled insulin before meals, coupled with a basal infusion of rapid-acting insulin by a subcutaneous pump will be examined to determine if this may result in a) improved metabolic control as measured by serial HbA1c; b) decreased events of ketosis; c) less severe hypoglycemic events (hypoglycemic event requiring assistance); and d) less symptomatic hypoglycemia.